lisdexamfetamine
Vyvanse (lisdexamfetamine) is one of the first-choice medications used to treat attention deficit-hyperactivity disorder (ADHD). It can also help treat binge eating disorder (BED) in adults. Vyvanse (lisdexamfetamine) is taken once per day and can start to work within a couple hours. But some common side effects include difficulty sleeping and loss of appetite. It's a controlled substance because it has a high risk of misuse and dependency.
What is Vyvanse (lisdexamfetamine)?
What is Vyvanse (lisdexamfetamine) used for?
Attention deficit-hyperactivity disorder (ADHD) - adults and children age 6 years and older
Moderate-to-severe binge eating disorder (BED) - adults only
How Vyvanse (lisdexamfetamine) works
Vyvanse (lisdexamfetamine) is a stimulant medication. It's not exactly known how Vyvanse (lisdexamfetamine) helps to improve attention or binge eating disorder. But it's thought to raise the levels of chemicals in your brain called norepinephrine, dopamine, and serotonin. Changes in the levels of these chemicals might affect your ability to focus, your appetite, and your urge to binge eat.
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What are the risks and warnings for Vyvanse (lisdexamfetamine)?
Vyvanse (lisdexamfetamine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Misuse and dependence
Risk factors: History of substance or alcohol use disorder | Suddenly stopping Vyvanse (lisdexamfetamine)
Vyvanse (lisdexamfetamine) has a risk of misuse and dependence. Misuse is when a medication is used differently than how it's prescribed. Misusing Vyvanse (lisdexamfetamine) raises your risk for serious side effects such as high heart rate, high blood pressure, aggressive behavior, and even thoughts of hurting yourself or others.
In addition, over time, you can become physically dependent on Vyvanse (lisdexamfetamine) to function normally. This is usually related to having withdrawal symptoms, such as feeling uneasy, slowed thinking, and depression, if you take the medication for a long time and then suddenly stop. Take Vyvanse (lisdexamfetamine) exactly as prescribed to you. Don't change the dose or how often you take it without talking to your provider first.
Serious heart problems
Risk factors: History of heart problems
There have been reports of sudden death, stroke, and heart attack in people who took stimulants like Vyvanse (lisdexamfetamine) at recommended doses. Vyvanse (lisdexamfetamine) can also raise your blood pressure and heart rate. Tell your healthcare provider if you have a history of heart problems before starting Vyvanse (lisdexamfetamine) to make sure it's safe for you to take. Let your provider know if you experience unexplained fainting, chest pain with physical activity, or irregular heartbeat while you're taking Vyvanse (lisdexamfetamine). Your provider will check your heart for any problems.
Changes in behavior or thoughts
Risk factors: History of psychotic episodes, bipolar disorder, or other mental health or mood-related conditions
Some people who've taken a stimulant like Vyvanse (lisdexamfetamine) can develop mental health problems, such as hallucinations (seeing things that aren't really there), abnormal or unclear thinking, and mania. This medication can worsen behavior- or thought-related problems that you already have, but these changes can also happen even if you haven't had these problems before. If you or a loved one notices that you've developed these mood- or behavior-related symptoms while taking Vyvanse (lisdexamfetamine), talk to your healthcare provider right away because you might have to stop taking it.
Slowed growth in children
Risk factors: Children ages 6 to 12
In studies, stimulants like Vyvanse (lisdexamfetamine) caused weight loss and slowed the growth rate (both height and weight) in children. Your child's healthcare provider will track your child's growth progress closely. If they suspect slowed growth, they might pause or stop your child's Vyvanse (lisdexamfetamine) treatment. If your child isn't getting enough nutrition, if you notice major changes in weight, or if you have any concerns, talk to your child's provider.
Blood circulation problems (such as Raynaud's phenomenon)
Vyvanse (lisdexamfetamine) can cause blood circulation problems, such as Raynaud's phenomenon, which can lower blood flow to your fingers and toes. This problem can cause your fingers or toes to change from a pale or blue color to a red color and feel cold, numb, or painful. If this happens, it's usually mild and happens occasionally. But rarely, it can cause sores to form and damage your tissue. Let your provider know if you experience any of these symptoms. Usually, symptoms of these blood vessel problems get better when the Vyvanse (lisdexamfetamine) dose is lowered or when the medication is stopped.
Serotonin syndrome
Risk factors: Taking monoamine oxidase inhibitors (MAOIs) 14 days before starting Vyvanse (lisdexamfetamine) | Taking other medications that raise serotonin levels in your brain
Serotonin syndrome is a rare, but potentially life-threatening condition where there's too much serotonin in the brain. Serotonin is one of the chemicals in your brain responsible for your mood. Your risk for this condition goes up if you use Vyvanse (lisdexamfetamine) with other medications that affect serotonin levels, such as antidepressants (e.g., sertraline (Zoloft), duloxetine (Cymbalta)), MAOIs (e.g., phenelzine (Nardil)), and certain migraine medications (e.g., sumatriptan (Imitrex)). Let your provider know about all the medications you take or plan to take before starting Vyvanse (lisdexamfetamine). Be aware of symptoms of serotonin syndrome, which include fast heart rate, sweating, muscle stiffness or spasms, high fever, and confusion. Get medical help right away if you have any of these symptoms.
Drug interactions
Vyvanse (lisdexamfetamine) can interact with many prescription and over-the-counter medications. For example, taking heartburn products called sodium bicarbonate and Zegerid (omeprazole / sodium bicarbonate) with Vyvanse (lisdexamfetamine) might raise the amount of Vyvanse (lisdexamfetamine) that gets absorbed into your body and raise your risk for side effects. Additionally, taking Vyvanse (lisdexamfetamine) with monoamine oxidase inhibitors (MAOIs), like selegiline and linezolid (Zyvox), can raise your risk of severely high blood pressure. It's best to avoid taking these types of medications with Vyvanse (lisdexamfetamine). Discuss with your provider about all of the medications you're taking before starting Vyvanse (lisdexamfetamine). Don't start any new medications while taking Vyvanse (lisdexamfetamine) without talking to your provider or pharmacist first. They can discuss with you about how to best manage your medications or find alternatives for you.
What are the side effects of Vyvanse (lisdexamfetamine)?
Common Side Effects
- Poor appetite (up to 39%)
- Difficulty sleeping (up to 27%)
- Dry mouth (26% in adults)
- Stomach pain (12% in children younger than 12 years old)
- Feeling irritable (10% in children younger than 12 years old)
- Dry mouth (36%)
- Difficulty sleeping (20%)
Other Side Effects
- Weight loss
- Poor appetite
- Nausea
- Vomiting
- Diarrhea
- Constipation
- Dry mouth
- Dizziness
- Anxiety
- Feeling jittery
- Faster heart rate
- Higher blood pressure
Serious Side Effects
- Heart problems: heart attack, high blood pressure, fast heart rate
- Brain-related problems: seizures, stroke
- Mental health-related problems: manic episodes, changes in thoughts or behavior, hallucinations
- Serotonin syndrome: fast heart rate, sweating, muscle stiffness or spasms, fever, confusion
Source:Â DailyMed
More on Vyvanse (lisdexamfetamine) side effects
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Heart attack—pain or tightness in the chest, shoulders, arms, or jaw, nausea, shortness of breath, cold or clammy skin, feeling faint or lightheaded
- Heart rhythm changes—fast or irregular heartbeat, dizziness, feeling faint or lightheaded, chest pain, trouble breathing
- Increase in blood pressure
- Irritability, confusion, fast or irregular heartbeat, muscle stiffness, twitching muscles, sweating, high fever, seizure, chills, vomiting, diarrhea, which may be signs of serotonin syndrome
- Mood and behavior changes—anxiety, nervousness, confusion, hallucinations, irritability, hostility, thoughts of suicide or self-harm, worsening mood, feelings of depression
- Prolonged or painful erection
- Raynaud syndrome—cool, numb, or painful fingers or toes that may change color from pale, to blue, to red
- Seizures
- Stroke—sudden numbness or weakness of the face, arm, or leg, trouble speaking, confusion, trouble walking, loss of balance or coordination, dizziness, severe headache, change in vision
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
- Dry mouth
- Headache
- Loss of appetite with weight loss
- Nausea
- Stomach pain
- Trouble sleeping
Pros and cons of Vyvanse (lisdexamfetamine)
Pros
A first-choice medication for ADHD
Works well for binge eating disorder
In children with ADHD, might start working within 1.5 hours and last for 13 hours
In adults with ADHD, might start working within 2 hours and last for 14 hours
If you have trouble swallowing pills, you can open the capsules and sprinkle contents onto certain foods, or switch to chewable tablets.
Cons
Has a risk of misuse and dependency
A controlled medication, so there are special requirements for getting the prescription filled
Dose needs to be raised and lowered slowly to avoid side effects and withdrawal symptoms
Not the best choice for pregnant or breastfeeding females or people with heart conditions
Pharmacist tips for Vyvanse (lisdexamfetamine)
Take Vyvanse (lisdexamfetamine) exactly as your provider instructed you to. Don't change your dose or studdenly stop taking the medication without talking to your provider first. Doing so can lead to bothersome withdrawal symptoms, such as daytime sleepiness, large appetite, feeling uneasy, slowed thinking, and depression. If you want to stop Vyvanse (lisdexamfetamine), your provider will lower your dose slowly over time before you can completely stop.
Take Vyvanse (lisdexamfetamine) as soon as you wake up to avoid trouble sleeping at night.
You can take Vyvanse (lisdexamfetamine) with or without food. But if possible, avoid acidic foods like fruit juice, citrus fruits, and vitamin C-rich foods. These foods and beverages might lower the amount of the medication that gets absorbed into your body, which might affect how well it works for you.
If you're having trouble swallowing the Vyvanse (lisdexamfetamine) capsules, you can open them, mix the contents with yogurt, water, or orange juice, and then consume the entire mixture right away. Don't crush or chew the capsules. This can damage the outside coating of the medication and lead to severe side effects or even a life-threatening overdose. Another option is to ask your provider to switch you to the chewable tablets.
It's recommended to avoid alcohol while taking Vyvanse (lisdexamfetamine) because it can make your ADHD symptoms worse. Drinking alcohol with Vyvanse (lisdexamfetamine) can also cause dangerous, severe side effects, including alcohol poisoning and heart problems.
Avoid driving the first few days after you start Vyvanse (lisdexamfetamine) and after any dose changes until you know how this medication affects you.
Vyvanse (lisdexamfetamine) can interact with a lot of common prescription and over-the-counter medications. Make sure to tell your provider about all the medications you're taking (including over-the-counter supplements) before starting Vyvanse (lisdexamfetamine). Don't start any new medications while taking Vyvanse (lisdexamfetamine) without talking to your provider or pharmacist first. They can make sure your medications are safe for you to take. Read more about drug interactions with Vyvanse (lisdexamfetamine) in the Risks and Warnings section.
Frequently asked questions about Vyvanse (lisdexamfetamine)
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Vyvanse (lisdexamfetamine) dosage forms
Typical dosing for Vyvanse (lisdexamfetamine)
ADHD (adults and children 6 years and older): The typical starting dose is 30 mg by mouth once per day in the morning. The recommended target dose is 30 mg to 70 mg once per day.
Binge eating disorder (adults only): The typical starting dose is 30 mg by mouth once per day. The recommended target dose is 50 mg to 70 mg once per day.
Your provider will slowly raise or lower your dose based on how well it's working to treat your symptoms or if you're having side effects. Your dose might also differ if you have kidney problems.
How much does Vyvanse (lisdexamfetamine) cost?
Vyvanse (lisdexamfetamine) contraindications
Severe allergy to amphetamine-containing products
Currently take or have taken an MAOI, linezolid (Zyvox), or methylene blue (ProvayBlue) in the last 14 days
What are alternatives to Vyvanse (lisdexamfetamine)?
Attention deficit-hyperactivity disorder (ADHD) - adults and children age 6 years and older
Moderate-to-severe binge eating disorder (BED) - adults only
Attention-deficit hyperactivity disorder (ADHD)
Attention-deficit hyperactivity disorder (ADHD) in adults and children age 6 years and older
What is the latest news about Vyvanse (lisdexamfetamine)?
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References
Best studies we foundAdvokat, C., et al. (2013). Attention-deficit hyperactivity disorder (ADHD) stimulant medications as cognitive enhancers. Frontiers in Neuroscience.
Drugs and Lactation Database (LactMed). (2023). Lisdexamfetamine. National Institute of Child Health and Human Development.
Gupta, M., et al. (2023). Withdrawal syndromes. StatPearls.
Inchiosa, M. A., Jr. (2011). Experience (mostly negative) with the use of sympathomimetic agents for weight loss. Journal of Obesity.
Jeffers, A., et al. (2013). Misuse of prescription stimulants for weight loss, psychosocial variables, and eating disordered behaviors. Appetite.
Martin, D., et al. (2023). Amphetamine. StatPearls.
MedlinePlus. (2021). Neonatal abstinence syndrome.
Moore, C. F., et al. (2018). Neuropharmacology of compulsive eating. Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences.
Office of Dietary Supplements. (2021). Vitamin C. National Institutes of Health.
Post, R.E., et al. (2012). Diagnosis and management of attention-deficit/hyperactivity disorder in adults. American Family Physician.
Takeda Pharmaceuticals America, Inc. (2023). VYVANSE- lisdexamfetamine dimesylate capsule. VYVANSE- lisdexamfetamine dimesylate tablet, chewable [package insert]. DailyMed.
U.S. Drug Enforcement Administration. (n.d.). Amphetamines.
U.S. Food and Drug Administration. (2021). Some medicines and driving don’t mix.
Vasan, S., et al. (2022). Amphetamine toxicity. StatPearls.
Vynase.com. (n.d.). Helped improve attention throughout the day in adults with ADHD.
Vynase.com. (n.d.). How to take Vyvanse (lisdexamfetamine dimesylate).
Vynase.com. (n.d.). Vyvanse helped treat ADHD throughout the day in children (aged 6-12).
Vynase.com. (n.d.). Vyvanse was proven effective in short-term studies.
Wolraich, M. L., et al. (2020). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics.
Zukkoor, S. (2015). The safety of stimulant medication use in cardiovascular and arrhythmia patients. American College of Cardiology.
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